[Psychiatric disorders in temporal lobe gliomas].

The rate of temporal lobe gliomas among all hemispheric gliomas is up to 1/3 cases. Psychiatric disorders are typical for temporal lesions and could be a single manifestation of the disease. There is a rich variety of different psychopathologic and epileptic signs exactly in cases of temporal gliomas in comparison to tumors with other localizations. Authors studied psychiatric disorders in a statistically significant group of patients (140 cases) with temporal lobe tumors. Side, localization, histology of lesion and functional asymmetry of patients (right- or left-handers) were taken into account. Psychiatric disorders were found in 74% of patients, mainly in cases of glioblastoma. Psychopathologic symptoms were more typical for left-sided lesions. The frequency of psychiatric disorders was significantly higher (p<0,05) in left-handers compared to right-handers. After surgical removal of tumor, the frequency of psychiatric disorders didn't differ significantly (p<0,05) by 2 years follow-up.

[Psychiatric disorders in temporal lobe gliomas].

The rate of temporal lobe gliomas among all hemispheric glial tumors is up to 30%. Psychiatric disorders are typical for temporal lesions and could be even single manifestation of the disease. There is a rich variety of different psychopathologic and epileptic signs exactly in cases of temporal gliomas in comparison to tumors of other localizations. In our study we investigated psychiatric disorders on statistically significant group of patients (140 cases) with temporal lobe tumors with considerations of side, localization, histology of lesion and functional asymmetry of patients. We revealed psychiatric disorders in 72% of patients, mainly in glioblastoma. Seizures were more typical for WHO Grade I and II gliomas. Psychopathologic symptoms were more typical for left side lesions. Lefthanders had psychiatric disorders significantly more frequently than righthanders (p < 0.05). After surgical removal of tumor the rate of psychiatric disorders didn't differ statistically (p < 0.05) by 2 years follow-up. Complete regress of seizures was observe in 56% of cases.

[Influence of molecular-genetic factors on prognosis in patients with oligodendroglial tumors].

Previous studies demonstrated that patients with oligodendroglial tumors (OT) have longer overall and recurrence free survival than patients with other glial tumors of the same grade. Recent investigations showed high influence of genetic alterations on patients' outcome: overall and recurrence free survival increased in the case of presence 1p19q deletion and decreased in the presence of 9p or 10q deletion and/or EGFR amplification. In the series of 241 cases (107 male, 134 female patients, median age -- 38 years, (16-73)) we analyzed the impact of histology, tumor grade and genetic alterations on time to tumor progression (TTP). All patients underwent surgical resection of tumor or biopsy from 2000 to 2005. 70 patterns (oligodendroglioma (O) -- 13 cases, oligoastrocytoma (OA) -- 13, anaplastic oligodendroglioma (AO) -- 30, anaplastic oligoastrocytoma (AOA) -- 14) were assessed by fluorescent in situ hybridization. Median follow up was 24 months. The type of tumor (pure or mixed) didn't influence survival. TTP of patients with grade II and grade III tumors was 37.7 and 48.2 months, respectively (p = 0.035). Deletion 1p19q was noted in 34 (49%) cases. In pure O codeletion 1p19q was detected more frequently (in O -- 75%, in AO -- 56%) than in mixed tumors (in OA -- 31%, in AOA -- 35%). Deletions 9p, 10q and EGFR amplification were noted in 5, 6 and 4 cases, respectively. None of the tumors with 1pl9q deletion had other genetic alterations. Thus, we generated three prognostic groups: A -- deletion 1p19q; B -- balanced chromosomal profile; C -- deletion 9p. Median TTP in groups A, B and C was 46.6, 25.3 and 6.4 months, respectively (p < 0.001). The percentage of OT with 1p19q codeletion was lower than in previous studies. Pure O more frequently had 1p19q deletion than mixed tumors. Genetic alterations predict outcome stronger than histological criteria.

[Neuronal heterotopy].

The diagnosis of most volumetric processes of the brain presents no difficulty today; however, there are a number of brain diseases whose clinical manifestations are similar to those of tumors. Despite the development of neurovisualization techniques (application of currently available computer and magnetic resonance tomographs and special programs, such as MR imaging and CT spectroscopy, diffusion and perfusion, etc.), some of these processes are difficult to differentiate from neoplasms noninvasively. It is evident that treatment policy should be quite different in these or those cases. Neuronal nodular heterotopy (ectopy) may be considered as one of such pseudotumorous processes. This case illustrates the rare abnormality that has the clinical and X-ray picture similar to that of neoplasms of the brain. Current noninvasive method do not always allow one to significantly verify the nature of brain tissue changes, which shows it necessary to use CT-stereotactic biopsy in some cases.

[Active surgical policy in severe advanced complications and sequels of concomitant brain injury (a clinical case)]. / Aktivnaia khirurgicheskaia taktika pri tiazhelykh zatianuvshikhsia oslozhneniiakh i posledstviiakh sochetannoi cherepno-mozgovoi travmy (klinicheskoe nabliudenie).

The paper presents a clinical case with a good outcome, which shows the advantages of active and stepwise surgical policy in concomitant chronic extra- and intracranial pyoinflammatory and dystrophic complications with severe liquorocirculatory disorders and extensive skull defect due to severe brain injury.

[EEG peculiarities in posttraumatic Korsakov's syndrome]. / Osobennosti EEG pri posttravmaticheskom korsakovskom sindrome.

The paper presents an attempt to define the structures of the cerebral functional pathologic system in the Korsakov's syndrome (KS) that develops after a severe craniocerebral trauma. 32 patients with reversible (21) and irreversible (11) KS variations were examined. Visual and coherent EEG-analysis was performed as well as determination of the three-dimensional location of the equivalent dipole sources of the separate pathologic components of the bioelectric activity. The data obtained were compared with the clinical ones. The role of both diencephalic and subcortical (including hippocampus) structures in KS development as well as the role of the right hemisphere were confirmed. Significance of the anterior (temporal-frontal-central) regions of the right hemisphere in KS regression was found. The degree of the injury of nonspecific frontal and brain stem structures and involvement of the left hemisphere into the pathological process together with the right one is essential for KS reversibility.

[Intercentral EEG relationships in regressive and chronic post-traumatic Korsakoff syndrome]. / Mezhtsentral'nye otnosheniia EEG pri regressiruiushchem i khronicheskom posttravmaticheskom Korsakovskom sindrome.

Dynamic EEG study of patients with posttraumatic Korsakoff's syndrome (KS) with the application of complex analysis methods revealed a complicated pathological structure of the intercentral relations of cortical electrical activity. The interhemispheric EEG coherence between symmetrical frontal cortical areas are sharply reduced, while the intrahemispheric coherence are increased in comparison with the normal values. The proposed technique of segregation of statistically homogeneous spectro-coherent characteristics made it possible to reveal the earlier intercentral EEG relations formed by stable and variable coherence spectra. The structure formed by the stable and variable coherence spectra in KS differs from that reflected in the mean coherence levels. During the KS regression, the EEG coherence between the right and left frontal areas increased to the normal level, and the variable spectra are revealed. In the chronic KS syndrome, the pathological intercentral relations persist, while the variable relations in the frontal areas are absent. A reduction of pathologically decreased intrahemispheric coherence selectively revealed in the right hemisphere during the KS regression and formation of variable relations in this hemisphere point to a leading role of the right hemisphere in development of compensatory processes in KS. The reciprocal relations between the intra- and interhemispheric coherence and coherence dynamics in the theta rhythm suggest that pathological activity in the basal diencephalic structures plays an important role in formation of the pathological EEG pattern in KS.

[An epileptic syndrome in patients with the sequelae of gunshot craniocerebral wounds]. / Epilepticheskii sindrom u bol'nykh s posledstviiami ognestrel'nykh cherepno-mozgovykh ranenii.

To study the specific features of the epileptic syndrome after present-day gunshot cranial wounds (GCW), as well as risk factors of its occurrence, 56 victims were examined prospectively (within at least a year after their admission). The epileptic syndrome developed in 18 (32.1%) patients within 1 to 15 months following GCW; there were prevalent generalized convulsive (in 13 of the 18 patients) and focal (in 12 of the 18 ones) seizures. One type of seizures was noted in 7 patients, two or three ones were in 11. The polymorphism of seizures and a disparity of their psychopathological structure to the side of brain lesion were typical for left-handers. As compared to other patients, epileptics were more commonly found to have: 1) frontoparietal lesion; 2) multiple bony defects of the vault of the skull; 3) enlargement of the lateral ventricle of the brain on CT scans; 4) primary coma for > 2 hours and other depressed consciousness syndromes for > 1 day; 5) signs of left-handedness. The findings suggest that there is a need for studies of the functional asymmetry of the brain to gain a better insight into the problem.